Exercise Recommendations for Individuals with ARFID

Direct Recommendation

Individuals with ARFID should engage in moderate-intensity aerobic exercise for at least 150 minutes per week combined with strengthening exercises twice weekly, while carefully monitoring for signs of energy depletion and adjusting intensity based on nutritional status and tolerance 1, 2

Target at least 150 minutes per week of moderate-intensity aerobic activity, spread across at least 3 days with no more than 2 consecutive days without exercise 1, 2
Moderate-intensity activities include brisk walking, slow cycling, recreational swimming, dancing, and gardening 3
Exercise can be performed alone or in groups, with slight benefit favoring group settings for adherence and psychosocial support 1, 2
Perform strengthening exercises at least twice weekly, targeting major muscle groups with 8-10 different exercises per session 1, 2
Begin with 1 set of 10-15 repetitions at low resistance (40% of one-repetition maximum) 4
Execute movements in a rhythmical manner at moderate to slow controlled speed through full range of motion 4
Allow at least 48 hours rest between sessions for any single muscle group 4

Screen for nutritional deficits and negative nitrogen balance as contributing factors to post-exertional exhaustion, as chronic malnutrition is common in ARFID patients 4
Start with shorter periods of low-intensity exercise and slowly increase intensity and duration, particularly in patients with significant nutritional compromise 5
Adjust intensity based on individual tolerance and disease severity 4
Avoid physical inactivity entirely—even light activity is preferable to sedentary behavior 6, 4
Exercise should complement, not replace, medical and nutritional treatment for ARFID 6, 4

Introduce low-to-moderate intensity aerobic exercise 2-3 times weekly for 20-30 minutes during the intermediate phase of nutritional rehabilitation 1, 2
Progress to full exercise recommendations of 150 minutes weekly aerobic plus twice-weekly resistance training during the maintenance phase of adequate nutrition 1, 2
Regular discussions between patients and healthcare professionals regarding exercise tolerance are essential given the complexity of ARFID and potential interactions between nutritional status and physical activity 1, 2, 6

Exercise provides benefits beyond weight management that are particularly relevant to ARFID patients, including improvements in pain, function, fatigue, and health-related quality of life 1, 2, 6
Exercise is safe when appropriately prescribed and monitored, with studies reporting few adverse events when intensity is matched to patient capabilities 1, 2, 6